A Panic attack can be life threatening?

[dmbfan07cb]

I've always read that a panic attack cannot kill you and you should not be afraid of them. Some tell me to just embrace it and tell the panic to do it's worse and that will help conquer the panic.  But during my most recent visit to the ER my heart rate was sustained at about 187bpm.  The doctors there very quickly gave me an IV and medicines to bring down my heart rate and all the while telling me a rate that high, sustained, can cause cardiac arrest.  So now this is more fear to bring to the table.  Here I was under the false impression that a panic attack was not dangerous, according to several reputable websites and self help tapes and so on.  Can anyone shed some light on why people consider a panic attack not dangerous when it very well can be life threatening? And maybe some of the people who are smart about these kinds of things; how long exactly could a healthy person sustain a heart rate near 200bpm before heart damage is done?

[JSGeare]

Nice to see you out and about, Dave Matthews Band Fan, and I, too, have always had some suspicion about that old saw that a panic attack can't kill you. They probably don't do so very often, but as a general rule of thumb, I get a bit uneasy whenever people say things like, "always, never, everybody, nobody" -and all the other absolutes which everybody always deploys to convince everyone that they are never wrong and which impress nobody. There! See what I mean?

My guess is that too much of ANYthing will kill us, so I see no reason for panic to be an exception. But on the other hand, my bet is that the record shows that there are precious few cases where panic actually HAS killed anyone. And there you are, a virile male down in Clarksville TN with (I presume) no incipient cardiac issues -so you would not appear to be very high on the list, right? The docs told you that a sustained 187 mph "can" cause cardiac arrest. Maybe so -and it was wise of them to bring you back down, of course. My guess is -and you can tell me I'm an idiot (take a number)- that if this was an ER deal, then nobody was spending a lot of time casually perusing your medical chart and chatting up your regular doc.  No, those folks were responding promptly to you case EXACTLY as it presented because if there WAS something "iffy" about your heart, running in the red line was probably not a swell idea. And so, they "shoot first and ask questions later."

Back to the real world, now. Panic attack is not considered life threatening in the literal sense for the same reason that the common cold is not considered life threatening -but I'll betcha the common cold has killed off a lot more people than panic attacks. All that said, if your particular case calls for a little something to put some kind of governor on your ticker, then by all means be guided accordingly. And by all means -and I really mean this- CHALLENGE your doctor or shrink on this one, because although you may not really be vulnerable -the argument about a too-fast heart rate makes some sense on the face of it. Hit 'em hard with this and then, please, please, please: tell us what they say.

Thanks for a great post.

[Pum]

Your doctor may decide to put you on a medication that means your heart can't go that high too often so make sure you follow through but my suggestion to let the panic attack happen is to try and shorten it. If you don't fight it you might find your heart rate goes down quite quickly.

A great author called Claire Weekes says athletes have those heart rates while exercising which always reassured me when my heart rate went very high. Ask the doctors about how high your rate has to be and for how long before you go to A&E.
There are questions like that on the heart rhythm forum.

Have you eliminated caffeine and cut down on alcohol? Both of those things helped my heart rate immensely. Of course now I worry that it is too slow (sometimes under 60 at rest but I have upped the exercise significantly)LOL, That's the curse of anxiety. Get rid of one worry and replace with another.

Good luck.

[Summer123]

Almost every time I go to the gym and check my heart rate on one of those machines, my heart rate climbs to near 200.  My hubby insists that that couldn't possibly be and the machines don't show that for anyone else that I've seen, but they do for me.  At first I worried about it, now I actually try to get it up to 200.  I know the exercise helps my anxiety and if I happen to have a heart attack and die well then I won't have to worry about my anxiety anymore.  However, leave it to a doctor to tell you whether you have a heart rate problem or an anxiety issue or both.  If you aren't satisified with the first doctor, you do have a right to a 2nd opinion.

[AJWS6]

I had very bad heart palpitations for a very long time, my heart rate rarely dipped below 95-100 bpm at rest and shot up to 180 bpm during panic, I was put on IV Morphine at the ER, to lower my heart rate & bp.  

I was very concerned about my heart rate, so I visit a cardiologist.  I had every test done in the cardiology dept, my cardiologist said I have a very healthy heart.  Well, to make a long story short.    

I started talking to my heart, thanking my heart for pounding so hard, telling my heart how great it felt, I was so alive, etc.....  At times I would, jump on my threadmill, tellin myself If my heart is going to beat a million miles an hour, I'm going to give it a reason, and if I die from a fast heart, at least I was doin something good for it.    

Well after a few weeks of this, it completely disappeared.  

I don't believe panic attack itself will kill a person, but can contribute to killing someone with an unhealthy heart or high bp.  

[RCA7591]

Dave Matthews, eh? Great band, man!

I read in your profile that you were stricken with anxiety/panic three years ago. You know, there are many underlying medical conditions that closely mimick the physical symptoms of panic disorder. Such a condition may go undiagnosed for many years (if ever). Often times, physical symptoms are misinterpreted by a person, which leads a practitioner to assume that anxiety/panic is the culprit - when, in fact, that may not be the case at all.

The sustained heart rate of 187 bpm is interesting, as this is NOT a common presentation in panic disorder, contrary to what you may have read elsewhere. That's not to say that it couldn't happen - merely that it is an uncommon response. As such, further work-up is indicated to exclude other possibilities...

I would recommend a complete cardiac work-up, including a 30-day event monitor to capture any form of arrhythmia that you may be experiencing. A transient arrhythmia, such as supraventricular tachycardia or Wollf-Parkinson-White syndrome would likely go undetected by other diagnostic modalities (due to their paroxsymal nature, they are troublesome to capture). With the event monitor, a simple press of a button during an "episode" records your EKG tracing, which may then be transmitted over the telephone for immediate evaluation.

Are there any potential triggers that you're aware of? For example, do these episodes occur while standing, lifting a heavy object, etc? Are you able to stand for more than 30 minutes without feeling ill?

What are your symptoms? (all of them, even if you think they may be insignificant). Any past history? (ie: Allergies, head trauma, anything). Any obvious external manifestations? (ie: cold extremities, skin lesions, rashes, etc). Do you take any medications or supplements?

Back to the heart rate:

Assuming an age of 22 years, your peak heart rate is: 220-22 = 198 bpm

Your target heart rate is: 220-22 = 198 (0.85) = 168 bpm

Assuming a structurally normal heart with a normal blood pressure response to exertion, a heart rate of 187 bpm is not hazardous. A sustained heart rate of 187 bpm (sustanied meaning in the absence of exertion) IS hazardous and requires immediate intervention (which was implemented). It doesn't matter what the cause is.

Ryan

[dmbfan07cb]

I get dizzy/faint upon standing after sitting or laying for long periods, and my heart rate increases upon standing significantly.  usually goes up to the 120's when I stand up. from my resting rate in the 90's.  I've never had problems with standing for long periods that i've noticed.  I Usually feel faint if I stand up from a crouching position.  Started taking xanax and the panic attacks have disappeared along with the high 160+ Heart rates.  When I was 20 I was on prozac for a year and did great never had any issues with my heart.  So i'm not convinced that something cardiac is causing my panic.  I don't have the money to go to a cardiologist, my recent ER visit is going to bankrupt me as it is.  ( I am actually going to have to file bankruptcy)  the only thing I could think that could have cause this was prozac. (if it is infact cardiac related)  
Now i'm just freaking out, I cant have this checked out, I have no money, I am just going to have to live with it i guess.